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Table of Content

    25 May 2025, Volume 46 Issue 5
    Previous Issue   
    The protective effect and mechanism of oxiracetam on primary fetal rat cortical neurons
    CAO Xu-hua1, WANG Li-yi2
    2025, 46(5):  507-513.  doi:10.3969/j.issn.1007-3205.2025.05.003
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    Objective To explore the protective effect and mechanism of oxiracetam on primary fetal rat cortical neurons and to analyze the key sites of oxiracetam acting on N-methyl-D-aspartic acid receptor (NMDA). 
    Methods By using calcium ion imaging technology and molecular docking techniques on primary fetal rat cortical neurons, the protective effect of oxacetam on neurons were described at the cellular and molecular level and the molecular mechanism was analyzed. 
    Results The results of cell culture of primary fetal rat cortical neurons showed that oxiracetam could ameliorate glutamate-induced neurotoxicity.Incubation with oxiracetam at varying concentration gradients for 1 min down-regulated glutamate-induced intracellular calcium ion (［Ca2+］i) elevation in a dose-response effect. As the concentration of oxiracetam increased to 30 μmol/L, the peak calcium concentration caused by glutamate was significantly reduced to (78.45±3.12)%, and the area under the curve (AUC) decreased to (77.06±1.39)%. Increasing the concentration of oxiracetam further did not result in significant changes in the peak calcium concentration.The final calculation showed that half maximal inhibitory concentration (IC50)of oxiracetam on peak increase in glutamate-induced ［Ca2+］i concentration was 15.34 μmol/L and that of AUC was 14.26 μmol/L, respectively. Oxiracetam binded to NMDA receptors at ASN-599, LEU-601, PRO-602, and GLN-604, with a binding energy of -3.34 kcal/mol. 
    Conclusion Oxiracetam can effectively bind to glutamate receptors and play a neuroprotective role in improving glutamate-induced intracellular calcium overload.

    Correlation between blood pressure variability and early neurological deterioration in patients with branch atheromatous disease
    ZHU Hui, JIN Di, WANG Ling-xiao, WANG Lei, YANG Jing, WANG Pei-fu
    2025, 46(5):  514-519.  doi:10.3969/j.issn.1007-3205.2025.05.004
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    Objective To analyze the association between blood pressure variability （BPV）  and early neurological deterioration (END) in patients with branch atheromatous disease (BAD). 
    Methods A total of 200 BAD patients were consecutively enrolled in Aerospace Central Hospital from Jan. 2022 to Jun. 2023, and National Institutes of Health Stroke Scale (NIHSS) score at 1 d, 3 d, and 7 d after admission were recorded. According to the increase in NIHSS score, they were divided into END (n=69) and non-END groups (n=131). The basic data, infarct site,laboratory indicators, and BPV were recorded. The influencing factors between two groups was analyzed using t-test and Logistic regression analysis. The area under receiver operator characteristic (ROC) curve (AUC) was used to analyze the diagnostic value of BPV indicators for END. 
    Results The fasting blood glucose, total cholesterol, low-density lipoprotein, infarct site, night mean systolic blood pressure （NMSBP)，  night mean diastolic blood pressure (NMDBP)， 24 hours systolic blood pressure standard deviation (24 hSBP-SD), day systolic blood pressure standard deviation（DSBP-SD）， night systolic blood pressure standard deviation (NSBP-SD), 24 hours diastolic blood pressure standard deviation (24 hDBP-SD), day diastolic blood pressure standard deviation (DDBP-SD), night diastolic blood pressure standard deviation （NDBP-SD)， day systolic blood pressure CV (DSBP- CV), night systolic blood pressure CV (NSBP- CV), 24 hours diastolic blood pressure CV (24 hDBP-CV), and day diastolic blood pressure CV (DDBP-CV) were compared between the two groups, showing significant differences (P＜0.05). T test， Logistic regression analysis and ROC curve were applied to statistical analysis. Logistic regression analysis showed that DSBP-SD, NSBP-SD, and DDBP-CV were independent risk factors for END in BAD patients (P＜0.05). The ROC curve revealed that the AUC of joint indicators of BPV was 0.746, and the specificity and sensitivity were 0. 817 and 0.609 respectively. 
    Conclusion Patients with BAD are subjected to END, and BPV is an important influencing factor, which can predict the occurrence of END. The monitoring of BPV provides a new idea for disease diagnosis and treatment. 

    Establishment and validation of a prediction model for fall risk in independently ambulatory patients with cerebral small vessel disease
    LIU Wan-hu1, MENG Ling-hui2, DONG Yu-juan1, LIU Cui-cui1, HU Xiao-kai1, REN Hui-ling1
    2025, 46(5):  520-526.  doi:10.3969/j.issn.1007-3205.2025.05.005
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    Objective To investigate the factors influencing the fall risk of independently ambulatory patients with cerebral small vessel disease(CSVD) based on neuroimaging characteristics and clinical factors, to develop a prediction model and to validate its efficacy. 
    Methods In total, 315 independently ambulatory patients with CSVD were selected in the Third Hospital of Hebei Medical University from Sept. 2021 to Sept. 2024 and divided into modelling group (n=196) and validation group (n=119) according to the 6∶4 principle. The timed up and go test was used to assess the fall risk of CSVD patients who could walk independently. Univariate and multivariate analyses was used to analyze independent risk factors for falls in independently ambulatory CSVD patients, a fall risk prediction model was constructed and a nomogram was plotted. The area under the receiver operating characteristic (ROC) curve (AUC) and calibration curve were used to evaluate the differentiation and calibration degree of the model in the modeling population and the verification population respectively. 
    Results Compared with the group without fall risk, the proportion of patients with advanced age, hypertension, history of fracture, cognitive impairment, moderate-to-severe white matter hyperintensity (WMH), moderate-to-severe perivascular spaces (EPVS), and lacunes was higher in the group with fall risk, showing significant differences (P＜0.05). Multivariate Logistic regression analysis showed that age (95%CI: 1.356-3.256), hypertension (95%CI: 1.119-6.682), cognitive impairment (95%CI: 1.146-7.423), moderate to severe WMH (95%CI: 1.487-8.363) and lacune (95%CI: 1.965-9.636) were independent risk factors for falls in independently ambulatory patients with CSVD (P＜0.05). Based on the above influencing factors, a nomogram model of the fall risk of independently ambulatory patients with CSVD was constructed. The AUC of the modeling population and the verification population was 0.855 and 0.921 respectively, indicating a high degree of model differentiation. The calibration curve showed that the prediction model was in good agreement with the actual observation results. 
    Conclusion Advanced age, hypertension, moderate-to-severe WMH, lacune, and cognitive impairment are independent risk factors for falls in independently ambulatory CSVD patients, and the clinical prediction model developed based on this study can better predict fall risk in independently ambulatory CSVD patients. 

    Establishment and evaluation of a nude mouse model of cisplatin-resistant lung cancer
    LI Zhi-ming1, WANG Fen2, LI Tong1, FAN Yi-nan3, ZHANG Yi-wen1, CHEN Ze-hui4
    2025, 46(5):  539-547.  doi:10.3969/j.issn.1007-3205.2025.05.008
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    Objective To establish a nude mouse model of cisplatin-resistant lung cancer and to evaluate the modeling effect. 
    Methods Human lung adenocarcinoma A549 cells and human lung adenocarcinoma cisplatin-resistant A549 cells (A549/DDP) were cultured in vitro, and cell suspensions were inoculated subcutaneously on the back of nude mice to construct a tumor-bearing nude mouse model of lung cancer. Tumor cells were separated and primary culture was performed. Cisplatin solution was selected as the experimental drug, and 10 groups were set up according to concentration gradients (0.125, 0.25, 0.5, 1, 2, 4, 8, 16, 32, and 64 mg/L) to intervene in A549 and A549/DD P cells, respectively. MTT assay was used to detect OD values at three time points (24 h, 48 h, and 72 h), to calculate cell inhibition rate. The half maximal inhibitory concentration (IC50) of cisplatin was obtained, to determine the multiples of drug resistance, and to verify whether the lung cancer model had cisplatin resistance properties. 
    Results ① With the increase of time and concentration, the inhibition rate of cisplatin on A549/DDP cells gradually increased, showing significant difference of interaction between groups, time points and time points between groups (P＜0.05). ②With the increase of time and concentration, the inhibition rate of cisplatin on A549 cells gradually increased, showing significant difference of interaction between groups and between time points (P＜0.05); there was an interaction between groups and time points (P＜0.05). ③At the same time and concentration, the inhibitory rate of cisplatin on A549 cells was significantly higher than that on A549/DDP cells, showing significant difference between groups (P＜0.05). ④With the increase of time, the IC50 of cisplatin on A549 and A549/DDP cells gradually decreased, showing significant difference of interaction between groups and between time points (P＜0.05); there was an interaction between groups and time points (P＜0.05). ⑤The multiples of drug resistance obtained after intervention for 24 h, 48 h, and 72 h were 12.395±1.209, 29.043±2.178, and 16.902±0.727, respectively; There was a significant difference between the groups (P＜0.05). All indicated a high degree of drug resistance of cells, with the optimal resistance observed at 48 h. 
    Conclusion A nude mouse model of cisplatin-resistant lung cancer can be successfully constructed by subcutaneous inoculation of A549/DDP cell suspension. This model can provide a good carrier for further studying the biological mechanisms of occurrence and evolution of drug resistance. 

    The application value of whole abdominal plain CT in the assessment of the efficacy of targeted therapy for gastrointestinal stromal tumours
    HAO Qing1, MA Chong-fei1, MI Chao-yi2, QI Ming-wei1, LI Yu1, YANG Li1
    2025, 46(5):  548-553.  doi:10.3969/j.issn.1007-3205.2025.05.009
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    Objective To evaluate the application value of whole abdominal plain CT in the assessment of the efficacy of targeted therapy for gastrointestinal stromal tumors (GIST). 
    Methods Fifty-three patients with pathologically confirmed GIST who received targeted therapy and had complete pre-and post-treatment imaging were retrospectively analyzed in the Fourth Hospital of Hebei Medical University from Mar. 2015 to Sept. 2022. The target lesions were selected with reference to the solid tumor efficacy evaluation criteria Response Evaluation Criteria in Solid Tumors (RECIST) 1.1. The length diameters and CT attenuation values of the target lesions before and after treatment were measured on the plain and venous images, respectively, and the rate of change in the sum of the length diameter and that in the mean CT value were calculated. Observations were made to determine the presence of new lesions, new hemorrhages in target lesions, and calcifications. Efficacies were evaluated according to both the RECIST1.1 and Choi criteria. The results of the efficacy assessment of the scanning and venous phases were compared. Radiation doses were recorded of each examination for both plain and enhanced CT scans. 
    Results The differences between the sum of the length diameters of the target lesions and the change rate of the sum of the length diameters measured in the plain and venous phases were not statistically significant (both P＞0.05) and were in good agreement ［intraclass correlation coefficient （ICC） values of 1.000 and 0.999, respectively］. The difference in the change rate of the mean CT values of the target lesions measured by both was statistically significant (P＜0.05), but the consistency was strong (ICC value of 0.672). Three new lesions, three intratumoral hemorrhages, and five intratumoral calcifications appeared after treatment, all of which could be identified by plain scanning. With reference to the RECIST1.1 criteria and Choi criteria, the consistency in the assessment results of the efficacy of the plain and venous phases was very strong, with Kappa values of 1.000 (P＜0.05) and 0.882 (P＜0.05), respectively. Radiation dose reduced approximately 70.11% for plain scan compared with enhanced scan. 
    Conclusion The whole abdominal plain CT scan reduces the radiation exposure and examination expenses of patients and can evaluate the targeted therapeutic effect of gastrointestinal stromal tumors relatively accurately, which has certain clinical application value. 

    The role of Nrf2-Keap1-ARE signaling pathway in the development of insulin resistance in the offspring of patients with gestational diabetes
    NUERBIYE Dilixiati, DILIHUMA Tuerxun, REMILA Aierken
    2025, 46(5):  561-566.  doi:10.3969/j.issn.1007-3205.2025.05.011
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    Objective To conduct an in-depth study of the mechanism of Nrf2-Keap1-ARE signaling pathway in the offspring of patients with gestational diabetes mellitus (GDM), and to pay special attention to its regulatory role in the occurrence of insulin resistance. 
    Methods Sixty successfully modeled rats were randomly divided into an empty lentivirus group (20 rats), an Nrf2 siRNA group (20 rats), and an insulin intervention group (20 rats). Rats in the three groups were intervened on the 5th day of pregnancy. After the empty lentivirus group completed modeling, 200uL of blank virus vector was injected into the tail vein. The Nrf2 siRNA group was injected with 200uL of Nrf2 siRNA vector. The insulin intervention group was injected with 4 U/kg of glargine insulin daily in the lower right abdomen of the rats. Three groups were all intervened for 2 weeks, and the glucose tolerance and insulin resistance, insulin tolerance, oxidative stress indicators in pancreatic tissue, Nrf2, Keap1, and ARE protein content and mRNA levels in pancreatic tissue of offspring rats were analyzed at 8, 16, and 24 weeks after birth. 
    Results The insulin resistance indexes at 8, 16, and 24 weeks after birth were 0.65±0.13, 1.03±0.31, and 2.81±0.65, respectivelyin the empty lentivirus group, 0.97±0.22, 1.74±0.77, and 2.98±0.95, respectivelyin the Nrf2 siRNA groups, and 1.08±0.39, 2.66±0.92, and 4.42±1.04, respectively in the insulin intervention group. The blood glucose concentrations at 8, 16, and 24 weeks after birth were (2.18±0.09), (3.05±0.35), and (4.34±2.10) mmol/L, respectively in the empty lentivirus group, (2.58±0.37), (3.18±0.77), and (4.92±2.08) mmol/L, respectively in the Nrf2 siRNA group, and (2.89±0.39), (4.69±1.47), and (6.18±2.33) mmol/L, respectively in the insulin intervention group. In the pancreatic tissue of offspring rats, the empty lentivirus group showed higher levels of oxidative stress, while the insulin intervention group showed lower levels of oxidative stress (P＜0.05). The mRNA levels of Nrf2, Keapl, and ARE in the empty lentivirus group were lower than those in the Nrf2 siRNA group and insulin intervention group (P＜0.05). 
    Conclusion Nrf2-Keap1-ARE signaling pathway may affect insulin sensitivity by regulating the level of oxidative stress, thus affecting the glucose metabolism of diabetic offspring during pregnancy. Activating this signaling pathway is expected to become a potential therapeutic strategy for the treatment of GDM and its related complications, providing new ideas for personalized clinical treatment. 

    Application of the "modified sandwich" technique with prosthetic patch for aortic root reconstruction in surgery for acute type A aortic dissection
    KONG Jia-jie, LIU Tong, LI Zhao-bin, XI Shu-qiang, LIU Lei
    2025, 46(5):  577-582.  doi:10.3969/j.issn.1007-3205.2025.05.014
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    Objective To observe the therapeutic effect of the "modified sandwich" technique with a prosthetic patch for aortic root reconstruction in surgery for acute type A aortic dissection. 
    Methods A retrospective analysis was conducted on the clinical data of 48 patients with acute type A aortic dissection who underwent aortic root reconstruction using the "modified sandwich" technique with a prosthetic patch. The surgical procedures and postoperative outcomes were statistically analyzed. 
    Results All 48 patients successfully underwent surgery. The median duration of cardiopulmonary bypass time was 196.5-307.5 min, and the median duration of aortic cross-clamp was 116.0-185.0 min. The median postoperative 24-h drainage volume was 308.8-845.0 mL. There were two perioperative deaths (4.167%), with causes attributed to renal failure with abdominal organ ischemia in one patient and coronary-related complications in the other. Postoperative complications included one patient (2.083%) undergoing re-exploration for hemostasis, which was unrelated to the vascular anastomosis, three patients (6.250%) requiring hemodialysis, one patient (2.083%) with paraplegia, and two patients (4.167%) with cerebral infarction and impaired left upper limb mobility. Additionally, one patient (2.083%) underwent tracheostomy, with a median mechanical ventilation duration of 48.0-121.0 h. Among the 46 recovered patients, pre-discharge follow-up with enhanced aortic CT revealed patent blood flow at the prosthetic vascular anastomosis site in all patients, except for one patient who exhibited residual dissection at the aortic sinus. 
    Conclusion The "modified sandwich" technique using a prosthetic patch for aortic root reconstruction during surgery for acute type A aortic dissection is a straightforward and effective method, easy to grasp, and can reduce anastomotic seepage, prevent anastomotic dehiscence and bleeding. Therefore, it is worthy of clinical popularization. 

    The significance of the DeRitis ratio in the evaluation of coronary artery lesions in pediatric patients with Kawasaki disease
    ZHAO Jun-shan, XIN Li, SUN Jun-feng, GUO Peng, MA Ying-ying, GAO Hong-liang
    2025, 46(5):  583-590.  doi:10.3969/j.issn.1007-3205.2025.05.015
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    Objective To evaluate the significance of DeRitis ratio and other biochemical markers in evaluating coronary artery lesions (CAL) in children with typical Kawasaki disease (KD). 
    Methods A total of 96 children with KD who were treated at Hebei Children′s Hospital from June 2022 to June 2024 were enrolled. Based on echocardiographic findings, patients were divided into two groups: the CAL+ group (with CAL complications, n=35) and the CAL- group (without CAL complications, n=61). The CAL+ group was further subdivided into patients whose coronary arteries recovered within 8 weeks of treatment (n=23) and those with persistent coronary artery dilation after 8 weeks (n=12). Peripheral venous blood samples were collected under fasting conditions during the acute phase of KD, clinical recovery phase, and at 8 weeks after intravenous immunoglobulin (IVIG) treatment. Liver function, myocardial enzyme profiles, and serum electrolytes were measured, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), creatine kinase (CK), creatine kinase isoenzyme MB (CK-MB), lactate dehydrogenase (LDH), and serum sodium levels. DeRitis ratio and LDH/AST ratio were calculated, and statistical analyses were performed. 
    Results ①During the acute phase of KD, the CAL+ group showed significantly higher DeRitis ratio compared with the CAL- group (1.74±0.68 vs. 1.16±0.32 vs. 0.76±0.24, F=26.858, P＜0.001). Furthermore, the DeRitis ratio in the CAL+ persistent dilation subgroup was higher than that in the CAL+ recovery subgroup (1.74±0.68 vs. 1.16±0.32, t=3.376, P=0.002), with both differences being statistically significant. ② At 8 weeks after IVIG treatment, the CAL+ persistent dilation subgroup exhibited a significantly higher DeRitis ratio compared with the CAL+ recovery subgroup (1.86±0.42 vs. 1.23±0.36, t=4.871, P＜0.001), indicating a significant difference. 
    Conclusion The DeRitis ratio and related biochemical markers are sensitive indicators for predicting the occurrence of CAL during the acute phase of typical KD. They also provide early prognostic insights into short-term outcomes in KD patients with CAL. 

    A follow-up study of retinal vascular obstructive disease in young patients
    CHEN Bo-ya, DUAN Jia-liang, XU Yan-ming, LIU Hou-yue, FU Hua, CAI Ze-yu
    2025, 46(5):  591-596.  doi:10.3969/j.issn.1007-3205.2025.05.016
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    Objective To analyze the long-term follow-up in young patients aged 40 years or younger diagnosed with retinal vascular occlusion (RVO), and to investigate the risk of cardiovascular and cerebrovascular events. 
    Methods Patients aged 40 years or younger and diagnosed with RVO at the Department of Ophthalmology, the Second Hospital of Hebei Medical University, from January 2008 to December 2016, were selected. Follow-up was conducted through medical record reviews, telephone calls, and outpatient visits. Data including the patient′s age, gender, affected eye, type of RVO, and medical history were recorded. 
    Results A total of 156 patients were successfully followed up. Among them, 140 had RVO (89.74%), 10 had retinal artery occlusion (6.41%), and 6 had both RVO and retinal artery occlusion (3.85%). There were 103 males (66.03%). The age of onset ranged from 17 to 40 years, with an average of (33.36±5.66) years and a median of 34.5 years. The average follow-up time was (10.71±2.62) years. A total of 45 patients had systemic diseases, including hypertension (42 patients), diabetes (8 patients), and hyperlipidemia (2 patients) before onset. During the follow-up period, 28 new cases of hypertension, 11 new cases of diabetes, and 7 new cases of hyperlipidemia were identified. Eight patients (5.13%) experienced cardiovascular events, including myocardial infarction (2 patients, 1.28%), cerebral infarction (2 patients, 1.28%), and coronary heart disease (5 patients, 3.21%), with one patient experiencing multiple cardiovascular events and one death. 
    Conclusion Young patients with RVO have a higher risk of cardiovascular and cerebrovascular events. When patients have hypertension, diabetes, hyperlipidemia and other high-risk factors that are prone to cardiovascular and cerebrovascular diseases, the probability of cardiovascular and cerebrovascular events can be reduced by controlling these high-risk factors. 

    Clinical value of ultrasound blood flow parameters combined with peripheral blood Gas6 in predicting fetal growth restriction in the third trimester of pregnancy
    LI Yu-Shuang1, XIA Bai1, WANG Jing1, ZHANG Yuan-yuan2
    2025, 46(5):  597-603.  doi:10.3969/j.issn.1007-3205.2025.05.017
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    Objective To investigate the clinical value of ultrasound blood flow parameters combined with peripheral blood growth arrest specific protein 6 (Gas6) in predicting fetal growth restriction (FGR) in the third trimester of pregnancy. 
    Methods A total of 285 pregnant women in the third trimester who were registered in the hospital from Jan.to Dec. 2022 were selected as the research subjects. All pregnant women underwent ultrasound examination and peripheral blood Gas6 examination, and were followed up until the end of pregnancy. They were divided into the occurrence group and the non-occurrence group according to the presence of FGR. The ultrasound blood flow parameters ［systolic and diastolic velocity ratio (S/D), resistance index (RI), pulsatility index (PI)］, peripheral blood Gas6 level and clinical data of the two groups were compared, and the influencing factors of FGR in the third trimester of pregnancy were analyzed by Logistic regression analysis. The receiver operating characteristic (ROC) curve was plotted and the predictive value was assessed by the area under the ROC curve (AUC). 
    Results Based on the follow-up until the end of pregnancy, 24 of 285 women in the third trimester developed FGR (8.42%), and the remaining 261 patients did not develop FGR. The proportion of cesarean section in the occurrence group was higher than that in the non-occurrence group (P＜0.05), and the newborn body weight in the occurrence group was lower than that in non-occurrence group (P＜0.05). The S/D (2.72±0.38), RI (0.85±0.17), and PI (1.08±0.32) of umbilical artery in the occurrence group were higher than those in the non-occurrence group ［(2.10±0.30), (0.59±0.13), (0.75±0.24)］ (P＜0.05). The S/D (3.41±0.48), RI (0.60±0.15), and PI (1.22±0.27) of uterine artery in the occurrence group were higher than those in the non-occurrence group ［(2.33±0.39), (0.37±0.08), (0.83±0.19)］ (P＜0.05). The level of Gas6 in peripheral blood of the occurrence group ［(12.67±2.41) g/L］ was higher than that in the non-occurrence group ［(9.25±1.78) g/L］ (P＜0.05). Uterine artery PI (OR=3.518, 95%CI: 1.547-8.004), fetal umbilical artery RI (OR=3.762, 95%CI: 1.654-8.558), fetal umbilical artery S/D (OR=2.907, 95%CI: 1.278-6.612) and peripheral blood Gas6 (OR=3.043, 95%CI: 1.338-6.923) were the influencing factors of FGR in the third trimester of pregnancy (P＜0.05).The AUC values of uterine artery PI, fetal umbilical artery RI, fetal umbilical artery S/D, peripheral blood Gas6 and their combination in predicting the incidence of FGR in pregnant women in the third trimester of pregnancy were 0.792, 0.803, 0.823, 0.815 and 0.899, respectively (P＜0.05), and the AUC value of the four indicators in combination was higher (P＜0.05). 
    Conclusion The ultrasound blood flow parameters (uterine artery PI, fetal umbilical artery RI, fetal umbilical artery S/D) and peripheral blood Gas6 have important value in predicting FGR in pregnant women in the third trimester of pregnancy, and the combination of the four indicators has higher predictive value. 

    Analysis of the relationship between platelet protein kinase C activity and short-term prognosis after Bentall surgery in patients with Stanford type A aortic dissection
    LI Xiao-ying1, HAO Cui-jun2, LI Fei-xing2, GAO Yang1, ZUO Lu-guang1, CHEN Xin-wei3
    2025, 46(5):  604-610.  doi:10.3969/j.issn.1007-3205.2025.05.018
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    Objective To observe the activity of platelet protein kinase C (PKC) in patients with Stanford type A aortic dissection (TAAD) and to analyze its relationship with short-term prognosis after Bentall surgery. 
    Methods In total, 216 TAAD patients who planned to undergo Bentall surgery in  the First Affiliated Hospital of Hebei North University from January 2020 to March 2023 were selected as the research subjects. All patients successfully underwent Bentall surgery, and their prognosis was evaluated based on the occurrence of adverse events within 30 d after surgery. They were divided into a poor prognosis group and a good prognosis group. The general data, platelet PKC activity and other laboratory indexes of the two groups were statistically analyzed, and the relationship between platelet PKC activity and short-term prognosis of TAAD patients after Bentall surgery was analyzed. 
    Results Adverse events occurred in 56 of 216 patients within 30 d after surgery, and the incidence of adverse events was 25.93% (56/216). The proportion of pericardial effusion (71.43%) and lower limb ischemia (33.93%) in the poor prognosis group was higher than that in the good prognosis group (55.00%, 20.00%). The diastolic blood pressure (DBP) on admission ［(72.29±4.58) mmHg］,  platelet cytoplasmic PKC activity ［(192.86±9.66) pmol·min-1·mg-1］, and platelet count ［(181.24±17.53)×109/L］ were lower than those in the good prognosis group ［(74.83±4.26) mmHg, (201.51±9.21) pmol·min-1·mg-1, (190.79±20.51)×109/L］. The PKC activity of platelet membrane ［(319.23±19.66) pmol·min-1·mg-1］ and D-dimer (DD) value ［(527.87±14.14) μg/L］ were higher than those in the good prognosis group ［(297.52±15.48) pmol·min-1·mg-1, (519.58±13.37) μg/L］, with significant differences (P＜0.05). Point-biserial correlation analysis showed that platelet cytoplasmic PKC activity was negatively correlated with the risk of short-term adverse prognosis in TAAD patients after Bentall surgery (r=-0.379, P＜0.05), while PKC activity of platelet membrane was positively correlated with the risk of short-term adverse prognosis in TAAD patients after surgery (r=0.498, P＜0.05). Logistic regression analysis found that DBP, platelet cytoplasmic PKC activity, PKC activity of platelet membrane, and DD levels at admission were all influencing factors for the short-term prognosis of TAAD patients after Bentall surgery (OR=0.844, 0.867, 1.069, 1.069, P＜0.05). The analysis of the receiver operating curve (ROC) revealed that the areas under the curve of platelet cytoplasmic PKC activity and PKC activity of platelet membrane, both alone and in combination, for predicting short-term poor prognosis in TAAD patients after Bentall surgery were 0.741, 0.800, and 0.879, respectively,with certain predictive value, and the combined detection had higher predictive value. 
    Conclusion Platelet PKC activity is related to the short-term prognosis of TAAD patients after Bentall surgery. The decrease in platelet cytoplasmic PKC activity and the increase in PKC activity of platelet membrane increase the risk of poor short-term prognosis in patients after surgery. Combined detection of the two can assist in early clinical screening of high-risk patients with poor prognosis. 

    Meta-analysis of interleukin-6 gene polymorphism and susceptibility to tuberculosis
    ZHANG Ya-long, CHENG Jun, LI Jiang, GAO Yu-feng
    2025, 46(5):  611-616.  doi:10.3969/j.issn.1007-3205.2025.05.019
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    Objective To investigate the relationship between genetic polymorphism of interleukin-6 (IL-6) and susceptibility to tuberculosis (TB). 
    Methods CNKI, WanFang, Pubmed and Web of Science databases were searched to collect studies on relationship between IL-6-174G/C (rs1800795), -572G/C(rs1800796) and susceptibility to TB until March 2024. Data were screened independently by two researchers using uniform inclusion criteria, and Meta-analysis was performed using STATA12.0. Combined odds ratio (OR) and its 95% confidence interval (95%CI) were used to evaluate the correlation strength. 
    Results Finally, 15 case-control studies were included, including 2 416 people in the TB group and 3 060 people in the healthy group. The results of Meta-analysis showed that the polymorphism of IL-6-174G/C was associated with the risk of TB infection ［C vs. G: OR=0.66，95%CI: 0.59-0.75, P＜0.001; CC+CG vs. GG: OR=0.67, 95%CI: 0.57-0.78, P＜0.001; CC vs. GC+GG:OR=0.48, 95%CI: 0.29-0.82, P=0.007; CC vs. GG: OR=0.38, 95%CI: 0.27-0.52, P＜0.001; CG vs. GG: OR=0.75, 95%CI: 0.63-0.88, P＜0.001］. IL-6-572G/C polymorphism was significantly associated with TB infection in the allele model (C vs. G)［ C vs. G:OR=0.87, 95%CI: 0.76-0.99, P=0.038］; however, it was not associated with the incidence of TB in the other four models ［CC+CG vs. GG: OR=0.72, 95%CI: 0.51-1.01，P=0.054; CC vs. GC+GG: OR=1.28, 95%CI: 0.61-2.72, P=0.512; CC vs. GG: OR=0.95, 95%CI: 0.54-1.67，P=0.867; CG vs. GG: OR=0.68, 95%CI: 0.46-1.02, P=0.060］. 
    Conclusion The 174G＞C and 572G＞C polymorphisms of the IL-6 gene may decrease the risk of TB development. 

    Study and analysis of plasma concentration and therapeutic efficacy of olanzapine combined with sodium valproate in the treatment of bipolar disorder
    YIN Jie, XUE Cai-xia, WEI Li-li
    2025, 46(5):  617-620,封三.  doi:10.3969/j.issn.1007-3205.2025.05.020
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    Objective To explore the relationship between plasma concentration and therapeutic efficacy of olanzapine combined with sodium valproate in patients with bipolar disorder. 
    Methods A total of 100 patients with bipolar disorder were included in the study from Jul. 2020 to Jan. 2023 and divided into three groups: the olanzapine group (n=33), the sodium valproate group (n=33), the combination of olanzapine and sodium valproate group (combination group) (n=34). All three groups received corresponding treatment for seven cycles. After treatment, the plasma concentration in each group was measured, and the improvement of symptoms was evaluated using Positive and Negative Syndrome Scale (PANSS). Bech-Rafaelsen Mania Rating Scale (BRMS) and Hamilton Depression Rating Scale (HAMD) were used to evaluate the therapeutic efficacy, and a dose-response curve was drawn to measure the therapeutic efficacy of olanzapine and sodium valproate. 
    Results The research results showed that for the combination group, the doses of olanzapine were (5.03±0.21) mg/d and (5.12±0.26) mg/d respectively at 15 and 30 d after treatment, and the plasma concentrations of sodium valproate were (593.02±20.28) μg/L and (612.98±21.27) μg/L, respectively. Compared with those before treatment, the blood concentration of olanzapine significantly increased at 30 d after treatment, from (27.58±1.36 ) μg/L to (29.53±1.59) μg/L, and the blood concentration of sodium valproate showed a more significant change, increasing from (53.39±5.53) μg/L to (84.96±6.59) μg/L, suggesting significant differences (P＜0.05). The combination group of olanzapine and sodium valproate showed significant improvement in both psychiatric and behavioral symptoms and efficacy compared with the olanzapine group or the sodium valproate group (P＜0.05). 
    Conclusion The combination therapy of olanzapine and sodium valproate can effectively adjust the plasma concentration of patients with bipolar disorder and improve therapeutic efficacy, providing a new treatment strategy for clinical treatment of bipolar disorder.